We present a case of an infected stent graft in the superficial femoral artery (SFA). A 67-year-old woman underwent excision of an infected Viabahn stent graft. At exploration there was no apparent artery around the majority of the stent graft, suggesting that the SFA had been autolysed. Infected stents and stent grafts are rare in the SFA position. The risk of infection is likely minimised with standard treatments including drainage of infection prior to stent graft placement and periprocedural antibiotic administration. Successful management will, in most cases, require excision of the stent graft and adjunctive arterial reconstruction, as necessary.

Objective: To evaluate outcomes following loss of primary patency (LPP) in superficial femoral (SFA) and popliteal (Pop) arteries treated by endovascular intervention (EVI)Methods:The medical records of all SFA/Pop EVI performed by 2 Vascular Surgeons between 2005-2008 were reviewed to identify LPP defined as occlusion or need for re-intervention documented by duplex or angiography. TASC II, EVI type, Rutherford Score (RS) and Rutherford Improvement Scores (RIS) were recorded. Analysis was completed with SPSS 15.Results: LPP occurred in 38 patients (31%) at 8.6 Ϯ 5.4 months. Twenty-four (63%) of these patients had EVI for critical limb ischemia (Rutherford Class 4-6). Mean follow up (FU) was 20 Ϯ 11 months. Neither TASC II, RS at primary EVI (PEVI) or EVI type had significant impact on RIS at LPP. RIS at LPP was worse than before PEVI in 55%. Re-intervention was performed in 79% of LLP patients. Patients who never showed significant improvement between PEVI and LPP were unlikely to improve at FU (Table I) despite a trend to undergo multiple re-interventions (55% vs. 13%; pϭ0.06). Survival and limb salvage at 24 months were 75% and 92%. Healing occurred in 46% of tissue loss patients at 11.9 Ϯ 11.6 months.Conclusion: EVI of the SFA/Pop arteries are not benign procedures. LPP occurred in nearly 1/3 of patients and 55% of those patients became worse than prior to PEVI. Despite reasonable limb salvage, healing occurred in only 46% and was delayed. Aggressive re-intervention after PLL may not improve outcome in patients who did not demonstrate significant interval improvement after PEVI.